Neurogastroenterology and Motility最新文献

{"title":"Intestinal Dysmotility and Associated Disorders in Intestinal Muscle of Methylglyoxal-Treated Mice.","authors":"Yuki Yamakawa, Taiki Mihara, Masatoshi Hori","doi":"10.1111/nmo.70068","DOIUrl":"10.1111/nmo.70068","url":null,"abstract":"<p><strong>Background: </strong>Peritoneal dialysis (PD) is a renal replacement therapy approach to treat end-stage renal failure. However, complications such as gastrointestinal dysmotility occur in patients undergoing PD, and the mechanisms underlying these complications have not been elucidated. We hypothesized that inflammation and dysfunction of the interstitial cells of Cajal (ICC) contribute to the PD-induced gastrointestinal dysmotility.</p><p><strong>Methods: </strong>Mice were intraperitoneally administered a dialysate containing methylglyoxal (40 mM) every other day for 2 weeks to mimic the gastrointestinal complications in patients undergoing long-term PD. The gastrointestinal transit capacity was evaluated using fluorescent dyes that were forcibly administered orally. To evaluate the inflammation and function of the ICC in the intestinal muscles, we performed real-time polymerase chain reaction and immunohistochemical staining and measured spontaneous contractions ex vivo.</p><p><strong>Key results: </strong>The intestinal transit capacity was significantly reduced in the methylglyoxal-treated group compared to that in the control group. In the inflammatory evaluation, the number of neutrophils and macrophages in the intestinal muscles significantly increased in the methylglyoxal-treated group compared to the control group. Moreover, the mRNA expression levels of Tnf, Il1b, and Il6 were upregulated in the intestinal muscle from the methylglyoxal-treated group. The mRNA expression of Kit, an interstitial cell of Cajal marker, was significantly decreased in the methylglyoxal-treated group. In addition, the frequency of spontaneous contractions, an index of ICC function, was decreased in the methylglyoxal-treated group.</p><p><strong>Conclusions and inference: </strong>Our data suggest that the PD-induced gastrointestinal dysmotility might be due to inflammation and dysfunction of the ICC in intestinal muscles.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70068"},"PeriodicalIF":2.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12435800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to Rossi et al.","authors":"Javier Aguilera-Lizarraga, Hind Hussein, María Cuende-Estévez, Guy Boeckxstaens","doi":"10.1111/nmo.70134","DOIUrl":"10.1111/nmo.70134","url":null,"abstract":"","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70134"},"PeriodicalIF":2.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144784871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Esophageal Hypervigilance and Mucosal Integrity Predict Symptom Outcomes in Reflux Patients With Normal Acid Exposure.","authors":"Wei-Yi Lei, Jen-Hung Wang, Chandra Prakash Gyawali, Chih-Hsun Yi, Tso-Tsai Liu, Jui-Sheng Hung, Ming-Wun Wong, Chien-Lin Chen","doi":"10.1111/nmo.70062","DOIUrl":"10.1111/nmo.70062","url":null,"abstract":"<p><strong>Background: </strong>Managing esophageal symptoms with normal acid exposure is challenging, requiring focus on both physiological and psychological factors. However, no studies have explored how patients perceive symptom changes after using alginates or proton-pump inhibitors (PPIs) in this context. This study examines the interrelationships among changes in reflux symptom severity, esophageal hypervigilance, and psychological distress in patients with normal esophageal acid exposure treated with either alginate suspension or PPIs.</p><p><strong>Methods: </strong>We conducted a 2-year prospective, randomized, open-label study with patients displaying typical reflux symptoms but normal acid exposure, confirmed via ambulatory pH-impedance monitoring. Participants completed validated questionnaires assessing esophageal hypervigilance and anxiety (EHAS), symptom severity, sleep quality, and depression at baseline and follow-up to evaluate symptom changes and predictors between treatments.</p><p><strong>Results: </strong>Among 146 patients (mean age: 47.9, 63% female), 75 received alginate and 71 PPI therapy. Improvements in questionnaire scores were significant across both treatments (p < 0.001), with no differences between groups. However, only a few patients in both groups achieved a > 50% reduction in gastro-esophageal reflux disease questionnaire (GERDQ) and global symptom severity (GSS) after treatment. Multivariable regression revealed that the reduction in esophageal hypervigilance and lower mean nocturnal baseline impedance (MNBI) were significant predictors of symptom improvement.</p><p><strong>Conclusion: </strong>In reflux patients with normal acid exposure, neither PPIs nor alginates alone effectively improved symptoms, but reducing esophageal hypervigilance and anxiety led to better outcomes. Mucosal integrity and EHAS scores are independent predictors of treatment response. The EHAS is a useful tool for assessing treatment impact and guiding personalized care. A comprehensive approach addressing both psychological and physiological factors is essential, especially for those with normal acid levels.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70062"},"PeriodicalIF":2.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143971965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mechanistic Gaps in Linking Aero- and Food Allergens to Irritable Bowel Syndrome.","authors":"Carlo Maria Rossi, Marco Vincenzo Lenti, Antonio Di Sabatino","doi":"10.1111/nmo.70122","DOIUrl":"10.1111/nmo.70122","url":null,"abstract":"","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70122"},"PeriodicalIF":2.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144608912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional Lumen Imaging Probe Measurement Post-Pneumatic Dilation in Clinically Relevant Esophagogastric Junction Outlet Obstruction.","authors":"James D Miller, Zachary L Mitchell, Abigail L Ellington, Felicia A Peoples, Steven B Clayton","doi":"10.1111/nmo.70053","DOIUrl":"10.1111/nmo.70053","url":null,"abstract":"<p><strong>Background: </strong>Pneumatic dilation (PD) is an effective treatment for disorders of reduced esophageal opening. Functional lumen impedance planimetry (FLIP) can effectively measure lower esophageal sphincter (LES) physiology compared to esophageal standards. The aim of this retrospective cohort analysis was to evaluate if FLIP measurements and esophageal opening classifications changed consistently with symptom improvement post-PD. Also, the aim was to determine if post-PD FLIP measurement correlated with the need for repeat dilation.</p><p><strong>Methods: </strong>Patients with clinically significant esophagogastric junction outlet obstruction (EGJOO) with reduced esophageal opening (REO) or borderline REO (BrEO) based on FLIP, timed barium esophagram (TBE), and manometry who underwent PD were included. Post-PD FLIP measurements were taken immediately after PD during the same endoscopy encounter.</p><p><strong>Results: </strong>After PD, average distensibility index (DI) increased from 1.5 mm²/mmHg to 4.7 mm²/mmHg (p < 0.001) and diameter changed from 8.9 mm to 15.9 mm (p < 0.001). Average post-dilation Eckardt score was 1.2, decreasing from an average pre-dilation score of 6.25. Of those requiring repeat dilations, average post-dilation DI was 4.5 mm²/mmHg and diameter 16.4 mm, not statistically different from those that did not undergo repeat procedure (p = 0.79, 0.67, respectively). Post-dilation esophageal openings were all NEO or BnEO. Average Eckardt score at 6-8 week follow-up was not significantly different from those who did not require repeat dilation (1.4, p = 0.112).</p><p><strong>Conclusions: </strong>PD appears to be associated with improved esophageal opening and a significant change in both DI and diameter, consistent with an improved Eckardt score. Post-dilation DI, diameter, esophageal opening pattern, and Eckardt score did not reveal a trend indicating the need for repeat dilation.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70053"},"PeriodicalIF":2.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12435797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changing Gastrointestinal Transit Time Alters Microbiome Composition and Bile Acid Metabolism: A Cross-Over Study in Healthy Volunteers.","authors":"Evette B M Hillman, Maximilian Baumgartner, Danielle Carson, Gregory C A Amos, Imad Wazir, Haider A Khan, Malik A Khan, Sjoerd Rijpkema, Julian R F Walters, Elizabeth M H Wellington, Ramesh Arasaradnam, Stephen J Lewis","doi":"10.1111/nmo.70075","DOIUrl":"10.1111/nmo.70075","url":null,"abstract":"<p><strong>Background: </strong>The specific influence of whole gut transit time (WGTT) on microbiome dynamics and bile acid metabolism remains unclear, despite links between changes in WGTT and certain gastrointestinal disorders. Our investigation aimed to determine the impact of WGTT changes on the composition of the fecal microbiome and bile acid profile.</p><p><strong>Methods: </strong>Healthy volunteers (n = 18) received loperamide, to decrease bowel movement frequency, and senna, a laxative, each over a 6-day period, in a randomized sequence, with a minimum 16-day interval between each treatment. Stool samples were analyzed for microbiome by shotgun sequencing and bile acid composition determined with high-performance liquid chromatography coupled to tandem mass spectrometry. Sera were examined for markers of bile acid synthesis.</p><p><strong>Key results: </strong>Senna or loperamide decreased or increased WGTT, respectively. Treatment altered stool characteristics, bowel movement frequency, and stool weight. The senna-treated group had increased primary and secondary fecal bile acids; serum levels of fibroblast growth factor 19 were significantly reduced. Increasing WGTT with loperamide led to an increase in bile salt hydrolase genes, along with elevated bacterial species richness (p = 0.04). Thirty-six species exhibiting significant differences were identified, several of which have notable implications for gut health. WGTT displayed negative correlations with total primary (particularly chenodeoxycholic acid) and secondary bile acids (ursodeoxycholic acid and glycochenodeoxycholic acid). Treatment-induced changes in microbiome composition and bile acid metabolism reverted back to baseline within 16 days.</p><p><strong>Conclusion: </strong>Whole gut transit time changes significantly affect fecal microbiome composition and function, as well as bile acid composition and synthesis in healthy subjects. This consideration is likely to have long-term implications.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70075"},"PeriodicalIF":2.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12435802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electroacupuncture Improves Intestinal Ischemia/Reperfusion Injury via cGAS-STING Pathway.","authors":"Yali Zhu, Chao Fang, Shuxian Chen, Ling Xiao, Jingcheng Wang, Yun Wu, Jia Zhan","doi":"10.1111/nmo.70066","DOIUrl":"10.1111/nmo.70066","url":null,"abstract":"<p><strong>Background: </strong>Electroacupuncture (EA) is a treatment method that stimulates acupuncture points to mobilize resistance to disease and bioelectricity to achieve therapeutic effects. Related studies have found that EA has a certain therapeutic effect on ischemia/reperfusion (I/R) injury of some organs. Among the internal organs, the intestine is the most sensitive to ischemic injury. Therefore, this study aims to preliminarily explore the effects and mechanisms of EA on intestinal I/R injury through animal experiments and provide a theoretical basis for the clinical treatment of intestinal I/R injury.</p><p><strong>Methods: </strong>In this study, the intestinal I/R injury model was established by occluding the superior mesenteric artery (SMA) of mice for 45 min and then reperfusing for 2 h. By applying EA to the bilateral Zusanli in mice, this study aimed to investigate its therapeutic effects on intestinal I/R injury.</p><p><strong>Key results: </strong>The results showed that EA can improve the survival and nutritional status of mice with intestinal I/R injury. EA alleviated intestinal tissue damage and the inflammatory response induced by intestinal I/R injury and protected the integrity of intestinal epithelial cells and intestinal transport function. Inflammatory factors induced by intestinal I/R injury were associated with increased levels of STING, and EA could inhibit the increase in STING protein levels and the phosphorylation of downstream factors IRF3 and TBK1 of the cGAS-STING pathway.</p><p><strong>Conclusions: </strong>EA can alleviate intestinal tissue damage caused by intestinal I/R in mice, protect the intestinal epithelial barrier, and improve intestinal transit function. The underlying mechanism may involve inhibition of cGAS-STING pathway activation and reduction of the inflammatory response.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70066"},"PeriodicalIF":2.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144102282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drug Survival of Drugs Recommended for Irritable Bowel Syndrome: A Retrospective Observational Study.","authors":"Alice Sandberg-Janzon, Pontus Karling","doi":"10.1111/nmo.70063","DOIUrl":"10.1111/nmo.70063","url":null,"abstract":"<p><strong>Background: </strong>There is limited data on how drugs prescribed for functional bowel disorders are re-prescribed in clinical practice. This study aimed to investigate drug survival rates of different irritable bowel syndrome (IBS) treatments among patients referred to a gastroenterologist.</p><p><strong>Methods: </strong>A retrospective observational study was conducted by reviewing medical charts of patients aged 18-50 years, diagnosed with IBS or an unspecified functional intestinal disorder between 2010 and 2018. Drug survival rates for various treatment categories were analyzed using Kaplan-Meier curves and log-rank tests.</p><p><strong>Results: </strong>A total of 1528 treatment attempts were recorded in 529 patients, with 883 classified as treatment-naïve. Simethicones demonstrated significantly higher drug survival compared to bulking agents (p = 0.009). Tricyclic antidepressants (TCA), loperamide, and simethicones all showed superior survival rates compared to osmotic laxatives (p = 0.039, p = 0.025 and p = 0.003, respectively). Additionally, loperamide and simethicones had better survival rates than antispasmodics (p = 0.046 and p = 0.012, respectively). At 60 months, the cumulative drug survival rate was highest for TCA (11%), followed by loperamide (10%) and simethicones (7%), all significantly outperforming bulking agents (1%) (p = 0.002 for TCA vs. bulking agents, p = 0.002 for loperamide vs. bulking agents, and p = 0.006 for simethicones vs. bulking agents). For all treatment-naïve attempts, the cumulative drug survival at 60 months was 6%.</p><p><strong>Conclusions: </strong>The overall 60-month drug survival for treatments prescribed in IBS is relatively low, suggesting that the effectiveness of current therapies remains limited. Among the medications studied, simethicone and TCAs demonstrated the best drug survival rates.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70063"},"PeriodicalIF":2.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12435799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional Foods in Gastrointestinal Health: The Role of Moringa, Artichoke, and Welsh Onion in Managing Diarrhea.","authors":"Slimen Selmi, Wael Taamalli, Mariem Mhimdi, Soumaya Wahabi, Nourhène Dhaouefi, Dhekra Grami, Hichem Sebai","doi":"10.1111/nmo.70069","DOIUrl":"10.1111/nmo.70069","url":null,"abstract":"<p><strong>Background and aim: </strong>Diarrhea is a prevalent gastrointestinal disorder with significant global health implications, often associated with disruptions in intestinal motility, barrier function, and fluid homeostasis. This study investigates the anti-diarrheal potential of three medicinal plants: Moringa oleifera, Cynara scolymus (artichoke), and Allium fistulosum (Welsh onion) sourced from organic farms in Tunisia, ensuring high-quality, pesticide-free material for experimental investigation in a rat model of castor oil-induced diarrhea.</p><p><strong>Methods: </strong>The plants were evaluated for their dietary fiber, mineral, and fatty acid composition to elucidate their biochemical properties. Wistar rats were treated with plant-based formulations before exposure to castor oil. Diarrhea severity, stool frequency, and intestinal motility were assessed. Biochemical analyses included oxidative stress markers and inflammatory cytokines, while histological examinations were performed to assess gut integrity.</p><p><strong>Results: </strong>All three plants demonstrated significant anti-diarrheal effects, with reductions in stool frequency, improved stool consistency, and modulation of gut motility. Biochemical analyses revealed enhanced antioxidant activity and suppression of pro-inflammatory cytokines, correlating with improved gut epithelial integrity. Moringa oleifera was particularly rich in potassium and magnesium, which are essential for fluid balance, while Cynara scolymus exhibited potent polyphenolic activity. Allium fistulosum provided a unique fatty acid profile that strengthened the gut barrier and mitigated inflammation.</p><p><strong>Conclusion: </strong>This study highlights the synergistic potential of Moringa oleifera, Cynara scolymus, and Allium fistulosum in alleviating diarrhea by targeting multiple pathological pathways, including oxidative stress, inflammation, and electrolyte imbalance. These findings support the development of plant-based functional foods and nutraceuticals as innovative strategies for managing gastrointestinal disorders.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70069"},"PeriodicalIF":2.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapeutic Role of Probiotics for the Treatment of Dyspepsia: A Review of the Literature.","authors":"Giovanni Marasco, Miriam Fiocca, Cesare Cremon, Luigi Colecchia, Marcello Maida, Elton Dajti, Maria Raffaella Barbaro, Vincenzo Stanghellini, Giovanni Barbara","doi":"10.1111/nmo.70057","DOIUrl":"10.1111/nmo.70057","url":null,"abstract":"<p><strong>Background: </strong>Dyspepsia is a common condition with a high prevalence in the general population. Patients in whom traditional diagnostic procedures can detect no identifiable explanation for the symptoms are diagnosed as being affected by functional dyspepsia (FD). To date, no etiological therapy for FD is available, and the current management includes general measures, acid-suppressive drugs, prokinetic agents, fundus-relaxing drugs, antidepressants, and psychological interventions. Recent evidence suggests that microbiota imbalance is involved in the development of FD. As a consequence, the modulation of microbiota through the use of probiotics could represent an effective therapeutic strategy. Moreover, Helicobacter pylori (HP) infection is a frequent cause of dyspepsia, and patients diagnosed with HP-associated dyspepsia are treated with HP eradication. In this regard, probiotics supplementation may also be helpful for HP infection to increase the eradication success rate as well as to reduce gastrointestinal adverse events caused by antibiotics.</p><p><strong>Purpose: </strong>This review of the literature aims to summarize and discuss the current evidence on the use of probiotics in the treatment of dyspepsia and as a supplement to HP eradication therapy.</p>","PeriodicalId":19123,"journal":{"name":"Neurogastroenterology and Motility","volume":" ","pages":"e70057"},"PeriodicalIF":2.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12435803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}